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EAGLE FAMILY MEDICINE, P.A.

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Company Details

Name: EAGLE FAMILY MEDICINE, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 05 Apr 2006 (19 years ago)
Financial Date End: 30 Apr 2026
Entity Number: 503857
Place of Formation: IDAHO
File Number: 503857
ZIP code: 83616
County: Ada County
Mailing Address: STE 136 323 EAST RIVERSIDE DRIVE EAGLE, ID 83616

Agent

Name Role Address
SHAWN NOWIESKI MD Agent 323 EAST RIVERSIDE DRIVE, STE 136, EAGLE, ID 83616

President

Name Role Address Appointed On
Shawn C Nowierski President 323 EAST RIVERSIDE DRIVE, EAGLE, ID 83616 2021-03-03

National Provider Identifier

NPI Number:
1417054693

Authorized Person:

Name:
DR. SHAWN CHRISTIAN NOWIERSKI
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2089393263

Filing

Filing Name Filing Number Filing date
Annual Report 0006147835 2025-03-07
Annual Report 0005629010 2024-03-04
Annual Report 0005131744 2023-03-03
Annual Report 0004636392 2022-03-07
Annual Report 0004188359 2021-03-03

USAspending Awards / Financial Assistance

Date:
2020-05-12
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
30000.00
Total Face Value Of Loan:
30000.00

Paycheck Protection Program

Jobs Reported:
5
Initial Approval Amount:
$30,000
Date Approved:
2020-05-12
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$30,000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$30,263.01
Servicing Lender:
Wells Fargo Bank, National Association
Use of Proceeds:
Payroll: $30,000

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Date of last update: 02 Jul 2025

Sources: Idaho Secretary of State